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Six months in general practice

Six months is a long time. I’ve had romantic liaisons that have spanned this duration, and exercise regimes which have lasted far less. It’s a length of time that still keeps things fresh but familiar, without the monotony that year upon year of the same person brings (sorry sweetheart). Six months ago to the day, I began my GP placement as a second-year GP trainee. Six months later, I am left with nothing but my memories and my mammaries, as a result of inevitable GP-induced weight gain.

Six months in hospital is like six weeks in hospital, or six years for that matter. Patients come and go. The sick get better or pass away, and new people take their place. For a few weeks you chase their bloods or fiddle with their medication but it’s not long before they’re on their way with only a discharge summary to remember you by. Occasionally you might see one again, if only as a name on a board in another ward. Six months in general practice is different.

Over the last half a year, I have had the pleasure to become a small part of my patient’s lives. When it boils down to it, being a GP is a bit like becoming someone’s friend without the small talk or the feigned enthusiasm in their hobbies. Frequently a GP needs only introduce themselves before a stranger explains their deepest fears and anxieties. This is hugely personal stuff, and a monumental privilege to hold.

As a result, my patients have become part of my life. I felt genuine happiness when a lady struggling with alcoholism and loneliness told me she was getting married. A young couple desperately trying to fall pregnant conceived – I bounced home that day. You can learn to nod and smile and acknowledge someone’s good news, but you can never learn intrinsic happiness.

Of course, often the news people get isn’t so good. I saw one lady almost weekly in my placement. I saw her more often than I see family. She has what is for me the most difficult problem to manage – she has a really awful life. Her husband is terminally ill. Her son is disabled. They are in debt and their house is totally unsuitable for them. She suffers with chronic pain and has no friends or support. Our consultations were nothing more than a chat – it was all I could offer. Over the weeks we talked about how she felt, and how she might feel when her husband passes on. We talked about how unsupported she felt and how isolated from the real world she was. She shared tears when her daughter’s marriage fell apart, and we shared laughter at stories of her grandchildren. For all intents and purposes, we became professional friends.

I’ll never know how much these chats meant to this lady. I hope she kept coming back because they were helpful, at least. They meant a lot to me – developing such a relationship is one of the biggest incentives of a career in general practice. I can’t make her husband better, or her son, or even make her pain go away. On the first day of medical school we were asked, “what is health?” We decided that health is the state of physical, mental, spiritual and social well-being. For this, companionship is crucial. The last six months make that clear.

Dr Danny Chapman is a GPST2 in North Devon. You can follow him on twitter @drdannychapman